Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T02:00:59.207Z Has data issue: false hasContentIssue false

Chapter 12 - Intracranial Hemorrhage

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

By
Crystal Wong ,
Khaled Aziz  and
Bertram Richter
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
Get access

Summary

Nontraumatic intracerebral hemorrhage affects more than one million per year worldwide and accounts for 10% of strokes in the United States. Aneurysm rupture is the most common cause of nontraumatic subarachnoid hemorrhage and is often associated with significant morbidity and mortality. Subdural and epidural hemorrhages may be induced by head trauma and can be life-threatening if not closely monitored and treated. The widespread use of systemic anticoagulation agents for cardiac and prothrombotic conditions raises the risk of all types of intracranial hemorrhage and presents unique challenges in acute management. Treatment of intracranial hemorrhage is geared toward minimizing hematoma expansion, reducing increased intracranial pressure, and surgically treating aneurysms, vascular malformations, and herniation syndromes.

Keywords

intracerebral hemorrhageGlasgow Coma Scaleanticoagulantsubarachnoid hemorrhagecerebral aneurysmsHunt Hess Grading Scalehydrocephaluselevated intracranial pressurevasospasmcerebral angiography
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 173 - 188
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abraham, MK, Chang, WTW. Subarachnoid hemorrhage. Emerg Med Clin 2016;34(4):901–916.Google Scholar
Al-Rawi, PG, Tseng, MY, Richards, HK, et al. Hypertonic saline in patients with poor-grade subarachnoid hemorrhage improves cerebral blood flow, brain tissue oxygen, and pH. Stroke 2010;41:122–128.CrossRefGoogle ScholarPubMed
Baharoglu, MI, Cordonnier, C, Al-Shahi Salman, R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral hemorrhage associated with antiplatelet therapy (PATCH): a randomized, open-label, phase 3 trial. Lancet 2016;387(10038):2605–2613.Google Scholar
Connolly, ES, Rabinstein, AA, Carhuapoma, JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. Stroke 2012;43:1711–1737.Google Scholar
Dastur, CK, Yu, W. Current management of spontaneous intracerebral hemorrhage. Stroke Vasc Neurol 2017;2:21–29.CrossRefGoogle Scholar
Dubosh, NM, Bellolio, MF, Rabinstein, AA, et al. Sensitivity of early brain computed tomography to exclude aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Stroke 2016;47:750–755.CrossRefGoogle ScholarPubMed
Frontera, JA, Lewin, JJ 3rd, Rabinstein, AA, et al. Guidelines for reversal of antithrombotics in intracranial hemorrhage: a statement for healthcare professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Neurocrit Care 2016;24(1):6–46.Google Scholar
Gehrie, E, Tormey, C. Novel oral anticoagulants: efficacy, laboratory measurement, and approaches to emergency reversal. Arch Pathol Lab Med 2015;139:687–692.CrossRefGoogle Scholar
Heit, JJ, Iv, M, Wintermark, M. Imaging of intracranial hemorrhage. J Stroke 2017;19(1):11–27.Google Scholar
Hemphill, JC 3rd, Greenberg, SM, Anderson, CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015;46(7):2032–2060.CrossRefGoogle ScholarPubMed
Panos, NG, Cook, AM, John, S, et al. Factor Xa inhibitor-related intracranial hemorrhage: results from a multicenter, observational cohort receiving prothrombin complex concentrates. Circulation 2020;141(21):1681–1689.CrossRefGoogle ScholarPubMed
Qureshi, A, Palesch, YY, Barsan, WG, et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med 2016;375(11):1033–1043.CrossRefGoogle ScholarPubMed
Sarode, R, Milling, T, Refaai, MA, et al. Efficacy and safety of a 4-factor prothrombin complex concentrate in patients on vitamin k antagonist presenting with major bleeding; a randomized, plasma-controlled, phase IIIb study. Circulation 2013;128:1234–1243.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×